§ 4.79 Schedule of ratings—eye.

Keratoconus (cone-shaped cornea)

A condition in which the cornea thins and bulges into a cone shape, distorting vision.

What the rating means

Keratoconus is rated under the General Rating Formula for Diseases of the Eye. VA evaluates it one of two ways — based on visual impairment caused by the condition, or based on incapacitating episodes — and uses whichever approach produces the higher rating.

Under the incapacitating-episodes path, the rating depends on how many treatment visits you had for the eye condition in the past 12 months. Seven or more visits yields 60%. At least 5 but fewer than 7 visits yields 40%. At least 3 but fewer than 5 visits yields 20%. At least 1 but fewer than 3 visits yields 10%. A visit counts only if you went specifically to receive treatment, not just for a routine check.

Under the visual-impairment path, VA measures how much the condition reduces your visual acuity or visual field, following the formulas in 38 CFR 4.75–4.78 and diagnostic codes 6061–6091. VA will apply whichever of the two approaches — incapacitating episodes or visual impairment — gives you the higher rating.

Evidence that helps

To support a rating based on incapacitating episodes, records that show the number of clinic visits in the past 12 months specifically for treatment of your keratoconus are central. The treatment examples listed in the regulation include systemic immunosuppressants or biologic agents, intravitreal or periocular injections, laser treatments, and other surgical interventions. Appointment records, clinical notes, and procedure logs that confirm each visit was for active treatment — not a routine exam — help establish the visit count at each rating level.

To support a rating based on visual impairment, eye examination records showing your best-corrected visual acuity and any visual field measurements are key. These findings are compared against the tables in 38 CFR 4.75–4.78. Your own statements, and those of people who know you, describing how reduced vision affects your work and daily activities can add context to the clinical findings, though the rating itself turns on the measured visual values.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.

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What the rating means

Evidence that helps

Secondary conditions

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